§ 32.1-276.4. Agreements for certain data services.
A. The Commissioner shall negotiate and enter into contracts or agreementswith a nonprofit organization for the compilation, storage, analysis, andevaluation of data submitted by health care providers pursuant to thischapter and for the development and administration of a methodology for themeasurement and review of the efficiency and productivity of health careproviders. Such nonprofit organization shall be governed by a board ofdirectors composed of representatives of state government, including theCommissioner, and the consumer, health care provider, and businesscommunities. Of the health care provider representatives, there shall be anequal number of hospital, nursing home, physician and health planrepresentatives. The articles of incorporation of such nonprofit organizationshall require the nomination of such board members by organizations andassociations representing those categories of persons specified forrepresentation on the board of directors.
B. In addition to providing for the compilation, storage, analysis, andevaluation services described in subsection A, any contract or agreement witha nonprofit, tax-exempt health data organization made pursuant to thissection shall require the board of directors of such organization to:
1. Develop and disseminate other health care cost and quality informationdesigned to assist businesses and consumers in purchasing health care andlong-term care services;
2. Prepare and make public summaries, compilations, or other supplementaryreports based on the data provided by health care providers pursuant to thischapter;
3. Collect, compile, and publish Health Employer Data and Information Set(HEDIS) information or reports or other quality of care or performanceinformation sets approved by the Board, pursuant to § 32.1-276.5, andsubmitted by health maintenance organizations or other health care plans;
4. Jointly determine with the Board of Medicine any data concerning safetyservices and quality health care services rendered by physicians to Medicaidrecipients that should be identified, collected, and disseminated. The boardof directors shall further determine jointly with the Board of Medicine thecosts of requiring physicians to identify, submit, or collect suchinformation and identify sufficient funding sources to appropriate tophysicians for the collection of the same. No physician shall be required tocollect or submit safety and quality of health care services information thatis already identified, collected, or submitted under this chapter; or forwhich funds for collection are not appropriated;
5. Maintain the confidentiality of data as set forth in § 32.1-276.9;
6. Submit a report to the Board, the Governor, and the General Assembly nolater than October 1 of each year for the preceding fiscal year. Such reportshall include a certified audit and provide information on theaccomplishments, priorities, and current and planned activities of thenonprofit organization;
7. Submit, as appropriate, strategic plans to the Board, the Governor, andthe General Assembly recommending specific data projects to be undertaken andspecifying data elements that will be required from health care providers. Indeveloping strategic plans, the nonprofit organization shall incorporatesimilar activities of other public and private entities to maximize thequality of data projects and to minimize the cost and duplication of dataprojects. In its strategic plans, the nonprofit organization shall alsoevaluate the continued need for and efficacy of current data initiatives,including the use of patient level data for public health purposes. Thenonprofit organization shall submit the first such strategic plan to theBoard, the Governor, and the General Assembly by October 1, 1996. Suchinitial plan shall include recommendations for measuring quality of care forall health care providers and for funding all data projects undertakenpursuant to this chapter. The approval of the General Assembly shall berequired prior to the implementation of any recommendations set forth in astrategic plan submitted pursuant to this section;
8. Competitively bid or competitively negotiate all aspects of all dataprojects, if feasible.
C. The Department shall take steps to increase public awareness of the dataand information available through the nonprofit organization's website andhow consumers can use the data and information when making decisions abouthealth care providers and services.
D. Except as provided in subdivision A 2 of § 2.2-4345, the provisions of theVirginia Public Procurement Act (§ 2.2-4300 et seq.) shall not apply to theactivities of the Commissioner authorized by this section. Funding forservices provided pursuant to any such contract or agreement shall come fromgeneral appropriations and from fees determined pursuant to § 32.1-276.8.
(1996, c. 902; 2000, c. 897; 2006, c. 426; 2010, c. 416.)
§ 32.1-276.4. Agreements for certain data services.
A. The Commissioner shall negotiate and enter into contracts or agreementswith a nonprofit organization for the compilation, storage, analysis, andevaluation of data submitted by health care providers pursuant to thischapter and for the development and administration of a methodology for themeasurement and review of the efficiency and productivity of health careproviders. Such nonprofit organization shall be governed by a board ofdirectors composed of representatives of state government, including theCommissioner, and the consumer, health care provider, and businesscommunities. Of the health care provider representatives, there shall be anequal number of hospital, nursing home, physician and health planrepresentatives. The articles of incorporation of such nonprofit organizationshall require the nomination of such board members by organizations andassociations representing those categories of persons specified forrepresentation on the board of directors.
B. In addition to providing for the compilation, storage, analysis, andevaluation services described in subsection A, any contract or agreement witha nonprofit, tax-exempt health data organization made pursuant to thissection shall require the board of directors of such organization to:
1. Develop and disseminate other health care cost and quality informationdesigned to assist businesses and consumers in purchasing health care andlong-term care services;
2. Prepare and make public summaries, compilations, or other supplementaryreports based on the data provided by health care providers pursuant to thischapter;
3. Collect, compile, and publish Health Employer Data and Information Set(HEDIS) information or reports or other quality of care or performanceinformation sets approved by the Board, pursuant to § 32.1-276.5, andsubmitted by health maintenance organizations or other health care plans;
4. Jointly determine with the Board of Medicine any data concerning safetyservices and quality health care services rendered by physicians to Medicaidrecipients that should be identified, collected, and disseminated. The boardof directors shall further determine jointly with the Board of Medicine thecosts of requiring physicians to identify, submit, or collect suchinformation and identify sufficient funding sources to appropriate tophysicians for the collection of the same. No physician shall be required tocollect or submit safety and quality of health care services information thatis already identified, collected, or submitted under this chapter; or forwhich funds for collection are not appropriated;
5. Maintain the confidentiality of data as set forth in § 32.1-276.9;
6. Submit a report to the Board, the Governor, and the General Assembly nolater than October 1 of each year for the preceding fiscal year. Such reportshall include a certified audit and provide information on theaccomplishments, priorities, and current and planned activities of thenonprofit organization;
7. Submit, as appropriate, strategic plans to the Board, the Governor, andthe General Assembly recommending specific data projects to be undertaken andspecifying data elements that will be required from health care providers. Indeveloping strategic plans, the nonprofit organization shall incorporatesimilar activities of other public and private entities to maximize thequality of data projects and to minimize the cost and duplication of dataprojects. In its strategic plans, the nonprofit organization shall alsoevaluate the continued need for and efficacy of current data initiatives,including the use of patient level data for public health purposes. Thenonprofit organization shall submit the first such strategic plan to theBoard, the Governor, and the General Assembly by October 1, 1996. Suchinitial plan shall include recommendations for measuring quality of care forall health care providers and for funding all data projects undertakenpursuant to this chapter. The approval of the General Assembly shall berequired prior to the implementation of any recommendations set forth in astrategic plan submitted pursuant to this section;
8. Competitively bid or competitively negotiate all aspects of all dataprojects, if feasible.
C. The Department shall take steps to increase public awareness of the dataand information available through the nonprofit organization's website andhow consumers can use the data and information when making decisions abouthealth care providers and services.
D. Except as provided in subdivision A 2 of § 2.2-4345, the provisions of theVirginia Public Procurement Act (§ 2.2-4300 et seq.) shall not apply to theactivities of the Commissioner authorized by this section. Funding forservices provided pursuant to any such contract or agreement shall come fromgeneral appropriations and from fees determined pursuant to § 32.1-276.8.
(1996, c. 902; 2000, c. 897; 2006, c. 426; 2010, c. 416.)
§ 32.1-276.4. Agreements for certain data services.
A. The Commissioner shall negotiate and enter into contracts or agreementswith a nonprofit organization for the compilation, storage, analysis, andevaluation of data submitted by health care providers pursuant to thischapter and for the development and administration of a methodology for themeasurement and review of the efficiency and productivity of health careproviders. Such nonprofit organization shall be governed by a board ofdirectors composed of representatives of state government, including theCommissioner, and the consumer, health care provider, and businesscommunities. Of the health care provider representatives, there shall be anequal number of hospital, nursing home, physician and health planrepresentatives. The articles of incorporation of such nonprofit organizationshall require the nomination of such board members by organizations andassociations representing those categories of persons specified forrepresentation on the board of directors.
B. In addition to providing for the compilation, storage, analysis, andevaluation services described in subsection A, any contract or agreement witha nonprofit, tax-exempt health data organization made pursuant to thissection shall require the board of directors of such organization to:
1. Develop and disseminate other health care cost and quality informationdesigned to assist businesses and consumers in purchasing health care andlong-term care services;
2. Prepare and make public summaries, compilations, or other supplementaryreports based on the data provided by health care providers pursuant to thischapter;
3. Collect, compile, and publish Health Employer Data and Information Set(HEDIS) information or reports or other quality of care or performanceinformation sets approved by the Board, pursuant to § 32.1-276.5, andsubmitted by health maintenance organizations or other health care plans;
4. Jointly determine with the Board of Medicine any data concerning safetyservices and quality health care services rendered by physicians to Medicaidrecipients that should be identified, collected, and disseminated. The boardof directors shall further determine jointly with the Board of Medicine thecosts of requiring physicians to identify, submit, or collect suchinformation and identify sufficient funding sources to appropriate tophysicians for the collection of the same. No physician shall be required tocollect or submit safety and quality of health care services information thatis already identified, collected, or submitted under this chapter; or forwhich funds for collection are not appropriated;
5. Maintain the confidentiality of data as set forth in § 32.1-276.9;
6. Submit a report to the Board, the Governor, and the General Assembly nolater than October 1 of each year for the preceding fiscal year. Such reportshall include a certified audit and provide information on theaccomplishments, priorities, and current and planned activities of thenonprofit organization;
7. Submit, as appropriate, strategic plans to the Board, the Governor, andthe General Assembly recommending specific data projects to be undertaken andspecifying data elements that will be required from health care providers. Indeveloping strategic plans, the nonprofit organization shall incorporatesimilar activities of other public and private entities to maximize thequality of data projects and to minimize the cost and duplication of dataprojects. In its strategic plans, the nonprofit organization shall alsoevaluate the continued need for and efficacy of current data initiatives,including the use of patient level data for public health purposes. Thenonprofit organization shall submit the first such strategic plan to theBoard, the Governor, and the General Assembly by October 1, 1996. Suchinitial plan shall include recommendations for measuring quality of care forall health care providers and for funding all data projects undertakenpursuant to this chapter. The approval of the General Assembly shall berequired prior to the implementation of any recommendations set forth in astrategic plan submitted pursuant to this section;
8. Competitively bid or competitively negotiate all aspects of all dataprojects, if feasible.
C. The Department shall take steps to increase public awareness of the dataand information available through the nonprofit organization's website andhow consumers can use the data and information when making decisions abouthealth care providers and services.
D. Except as provided in subdivision A 2 of § 2.2-4345, the provisions of theVirginia Public Procurement Act (§ 2.2-4300 et seq.) shall not apply to theactivities of the Commissioner authorized by this section. Funding forservices provided pursuant to any such contract or agreement shall come fromgeneral appropriations and from fees determined pursuant to § 32.1-276.8.
(1996, c. 902; 2000, c. 897; 2006, c. 426; 2010, c. 416.)
